Abstract：
This meta-analysis aimed to determine whether peripheral nerve blocks (PNB) reduce postoperative delirium (POD) in elderly patients undergoing hip surgery. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022328320). The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for randomized controlled trials (RCTs) on 26 April 2022. A total of 19 RCTs with 1977 participants were included. Perioperative PNB lowered the POD incidence on the third postoperative day (OR: 0.59, 95% CI [0.40 to 0.87], p = 0.007, I2 = 35%), in patients without underlying cognitive impairment (OR: 0.47, 95% CI [0.30 to 0.74], p = 0.001, I2 = 30%), and when a fascia iliaca compartment block (OR: 0.58, 95% CI [0.37 to 0.91], p = 0.02, I2 = 0%) or a femoral nerve block (OR: 0.33, 95% CI [0.11 to 0.99], p = 0.05, I2 = 66%) were performed. The pain score was also reduced (SMD: -0.83, 95% CI [-1.36 to -0.30], p = 0.002, I2 = 95%) after PNB. Perioperative PNB can lower the POD incidence and pain scores up to the third postoperative day. However, considering the wide variety of PNBs performed, more trials are needed to identify the effects of each PNB on POD.
摘要：
这项荟萃分析旨在确定周围神经阻滞（PNB）是否可以减少老年髋部手术患者的术后谵妄（POD）。本研究已在国际前瞻性系统审查注册（PROSPERO;CRD42022328320）中注册。PubMed,EMBASE,WebofScience,和CochraneLibrary数据库在2022年4月26日搜索了随机对照试验(RCT).共纳入19项RCT，1977名参与者。围手术期PNB降低了术后第三天的POD发生率(OR:0.59,95%CI[0.40to0.87],p=0.007,I2=35%),在无潜在认知障碍的患者中(OR：0.47，95%CI[0.30至0.74]，p=0.001，I2=30%)，和髂筋膜室传导阻滞时（OR：0.58，95%CI[0.37to0.91]，p=0.02，I2=0%）或股神经阻滞（OR：0.33，95%CI[0.11至0.99]，p=0.05，I2=66%)。疼痛评分也降低（SMD：-0.83，95%CI[-1.36至-0.30]，PNB后p=0.002，I2=95%）。围手术期PNB可以降低POD发生率和疼痛评分，直至术后第三天。然而,考虑到执行的各种各样的PNB，需要更多的试验来确定每种PNB对POD的影响.
